Percutaneous radiofrequency and microwave ablation in the treatment of renal tumors - 10 years of experience.

Abstract

IntroductionThe standard radical treatment of renal cell carcinoma is surgical resection, but it is not suitable for patients with serious medical comorbidities and solitary kidney tumors. Minimally invasive ablation techniques could be an appropriate therapeutic alternative.AimTo retrospectively evaluate the technical success, mid-term and long-term efficacy and safety of radiofrequency and microwave ablation in patients with small renal tumors.Material and methodsOver the course of 10 years, 91 ablation procedures in 64 patients for 68 tumors, of size 12–60 mm, were performed using only conscious sedation. These ablations were done under the guidance of computed tomography. We treated 41 males and 23 females with solitary kidney tumors (14 cases) and tumors in non-surgical candidates (54 cases).ResultsIn 50 (73.5%) tumors single treatment was successful; in 13 (19.1%) cases a second procedure was used successfully, and in the 5 largest tumors (sizes 45–60 mm, 7.4%) a third treatment was necessary. Within the follow-up 10 (15.6%) patients died, but none due to metastatic renal cell carcinoma. Only 1 serious complication was observed – retroperitoneal and psoatic hematoma. Early recurrence occurred in 18 (26.5%) tumors. Late recurrence was detected in 5 (7.4%) cases. In all cases complete local control of the renal tumors was reached.ConclusionsPercutaneous ablation is a very effective treatment for patients with small renal tumors of the T1a group with a minimal complication rate.

Local ablation vs partial nephrectomy in T1N0M0 renal cell carcinoma: An inverse probability of treatment weighting analysis

“…RCC size also affects the success rate of LA treatment. It has been reported that 26.5% of patients need to undergo two or more LA operations to achieve successful treatment, especially for large RCC; for tumors >4.5 cm, approximately 7.4% of patients undergo LA treatment 44 . Mauri et al 45 reported that among 149 patients treated with thermal ablations with a median follow‐up of 54 months, 18.1% received multiple successful ablations due to incomplete ablation, local tumor progression, distant tumor progression, or multiple tumor foci.…”

“…It has been reported that 26.5% of patients need to undergo two or more LA operations to achieve successful treatment, especially for large RCC; for tumors >4.5 cm, approximately 7.4% of patients undergo LA treatment. 44 Mauri et al 45 reported that among 149 patients treated with thermal ablations with a median follow-up of 54 months, 18.1% received multiple successful ablations due to incomplete ablation, local tumor progression, distant tumor progression, or multiple tumor foci. Simultaneous use of ultrasound and computed tomography in ablation surgery can improve the ability to immediately detect RCC tissue that has not been sufficiently ablated, thereby guiding immediate secondary ablation.…”

Percutaneous microwave ablation of renal cell carcinoma: practice guidelines of the ultrasound committee of Chinese medical association, interventional oncology committee of Chinese research hospital association

“…There is an extensive evidence in the literatures from metaanalysis, cohort studies, and case series on the technical outcomes, the safety and the effectiveness of the use of MWA for the treatment of T1a RCCs [15,27,[42][43][44][45][46][47][48][49][50][51][52][53] (Table 2). All the literatures reported the MWA of RCC under US or CT guidance.…”

Predictive value of the albumin-bilirubin grade on long-term outcomes of CT-guided percutaneous microwave ablation in intrahepatic cholangiocarcinoma

“…Image-guided local ablation therapy was introduced as a radical treatment, which was useful to improve overall survival (OS) of patients [7][8][9]. Radiofrequency ablation (RFA) and microwave ablation (MWA) are two most often performed ablative treatments.…”